Uncertain futures : communication and culture in childhood cancer treatment

著者

    • Clemente, Ignasi

書誌事項

Uncertain futures : communication and culture in childhood cancer treatment

Ignasi Clemente

（Blackwell studies in discourse and culture / editor James M. Wilce, 7）

Wiley Blackwell, 2015

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注記

Includes bibliographical references and index

内容説明・目次

内容説明

This book examines children and young people's attempts to participate in conversations about their own treatment throughout uncertain cancer trajectories, including the events leading up to diagnosis, treatment, remission, relapse, and cure or death. Clearly and compellingly written, Clemente relies on a new multi-layered method to identify six cancer communication strategies Illustrates that communication is central to how children, parents, and healthcare professionals constitute, influence, and make sense of the social worlds they inhabit-or that they want to inhabit Provides ethnographic case studies of childhood cancer patients in Spain, using children's own words Examines the challenges of how to talk to and how to encourage patients' involvement in reatment discussions In his critique of the "telling" versus "not telling" debates, Clemente argues that communication should be adjusted to the children's own needs, and that children's own questions can indicate how much or little they want to be involved Uncertain Futures is the winner of the 15th Annual Modest Reixach Prize.

目次

Series Preface ix Acknowledgments xii Preface xiv 1. Children: Contributions to Communication and Illness 1 Alternatives to Speaking 5 Disclosure as a Dynamic and Heterogeneous Process 7 Disclosure to Children with Cancer 10 Problematizing Participation 13 Uncertainty and the Practice of Optimism 21 Multiple Uncertainties 21 Hierarchically Organized Uncertainties 23 Variable Uncertainties 23 Practicing Hope and Optimism 25 Ethnography and Conversation Analysis 26 Plan of the Book 31 2. A Linguistic Anthropologist in a Pediatric Cancer Unit 33 Culture and Disclosure Practices in Catalonia 34 Fieldwork with Children 38 Contexts of Children's Questions 42 Investigating Avoidance 44 Multiple Ways of Talking about Cancer 47 3. Living and Dealing with Cancer 49 Focusing on Treatment 51 Guessing 55 Estar baixet (Having Low Blood Cell Counts) 56 Les llagues (Mouth Sores) 57 La febre (Fever and Infections) 58 Being Together 60 Acompanyar (Being at the Patient's Side) 61 Menjar (Eating) 63 Fer una visita (Visiting) 64 Talking Privately 67 Uncertainties of Treatment 71 4. Co ]constructing Uncertainty 74 Questions and Answers 76 Uncertainty and the Topic of Questions 79 Contingent Answers 80 Contingent Questions 86 Uncertainty and the Action of Questions 88 Answers that Lead to Subsequent Actions 90 Avoiding Answers and Avoiding Silence 93 Stepping into the Uncertain Future One Turn at a Time 100 5. Engaging in Communication at Catalonia Hospital 102 Learning the Diagnosis 103 L'entrevista (The Treatment Interview) 109 "And When Will I Be Completely Cured?" 111 Six Communication Strategies 127 6. Patient Pressure and Medical Authority 129 Everyday Life in Treatment 130 "How Many Chemos Do I Have Left?" 133 Seeking Answers Without Challenging Medical Authority 151 7. The Limits of Optimism at the End of Treatment 153 Remission 154 Relapse 159 Negotiating Death 161 "Is the Day of the Autotransplant Going to Be Delayed?" 168 Optimistic Collusion 178 8. Conclusion 180 Appendix A: Profiles of Patients 189 Children (ages 3-6) 189 Young people (ages 11-18) 190 Appendix B: Transcription Conventions 193 References 197 Index 214

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